Early Stages Of Chronic Disease Research Articles

Revealing chronic disease progression patterns using Gaussian process for stage inference.

The early stages of chronic disease typically progress slowly, so symptoms are usually only noticed until the disease is advanced. Slow progression and heterogeneous manifestations make it challenging to model the transition from normal to disease status. As patient conditions are only observed at discrete timestamps with varying intervals, an incomplete understanding of disease progression and heterogeneity affects clinical practice and drug development. We developed the Gaussian Process for Stage Inference (GPSI) approach to uncover chronic disease progression patterns and assess the dynamic contribution of clinical features. We tested the ability of the GPSI to reliably stratify synthetic and real-world data for osteoarthritis (OA) in the Osteoarthritis Initiative (OAI), bipolar disorder (BP) in the Adolescent Brain Cognitive Development Study (ABCD), and hepatocellular carcinoma (HCC) in the UTHealth and The Cancer Genome Atlas (TCGA). First, GPSI identified two subgroups of OA based on image features, where these subgroups corresponded to different genotypes, indicating the bone-remodeling and overweight-related pathways. Second, GPSI differentiated BP into two distinct developmental patterns and defined the contribution of specific brain region atrophy from early to advanced disease stages, demonstrating the ability of the GPSI to identify diagnostic subgroups. Third, HCC progression patterns were well reproduced in the two independent UTHealth and TCGA datasets. Our study demonstrated that an unsupervised approach can disentangle temporal and phenotypic heterogeneity and identify population subgroups with common patterns of disease progression. Based on the differences in these features across stages, physicians can better tailor treatment plans and medications to individual patients.

Learnings from Implementing Telemonitoring in South West Sydney (LITE in SWS)

The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 5.120 (2020 JCR, received in June 2021)The IJIC 20th Anniversary Issue was published in 2021.

Marcadores moleculares tumorais

Introdução: Câncer é o nome dado a um conjunto de mais de 100 doenças que tem em comum o crescimento desordenado de células que invadem órgãos e tecidos podendo espalhar-se para outras regiões do corpo. A identificação dos estágios iniciais das doenças crônicas pode reduzir taxas de morbidade e mortalidade, o que pode ser realizado por meio de três níveis de programas de prevenção. Cunhou-se o termo biomarcador para qualquer molécula ou característica biológica que possa ser detectada e medida revelando processos biológicos normais, patológicos ou a resposta farmacológica após intervenção terapêutica. A incidência do câncer cresce no Brasil, como em todo o mundo, num ritmo que acompanha o envelhecimento populacional decorrente do aumento da expectativa de vida. Esta Revisão de Literatura objetiva realizar um levantamento dos marcadores tumorais utilizados na detecção, diagnóstico e prognóstico dos tipos de câncer mais incidentes na população brasileira. Metodologia: Foi realizado um levantamento bibliográfico integrou livros e periódicos nacionais e internacionais indexados em bases de dados online - Bireme, PubMed e SciELO. Conclusão: O câncer é um problema de saúde pública em todo o mundo, portanto, métodos diagnósticos capazes de prevê-lo são realmente muito significativos. Marcadores tumorais são macromoléculas presentes no sangue ou em outros líquidos corporais, cuja presença geralmente está associada ao aparecimento de um tumor. Exames laboratoriais geralmente são solicitados a fim de fazer a triagem para prevenir uma doença, estabelecer um diagnóstico, orientar o tratamento ou avaliar o prognóstico. Sendo assim, apesar de possuir limitações, os marcadores tumorais cumprem essas finalidades. A literatura nacional disponível sobre o assunto “marcadores tumorais” ainda é muito limitada. Conhecer mais sobre o câncer ajudaria a evitá-lo ou, em último caso, orientaria as pessoas a procurar auxílio desde o início.

Caregiving Burden of the Dyad in Cancer Situations

Objective: To analyze the relationship of the care burden of the dyad in cancer situations in Bogotá. Methodology: Quantitative and correlation with standard dyadic design of reciprocal type. The sample consisted of 80 dyads (Caregiver-Cancer Patient). A characterization card of the dyad, caretaker - person with chronic illness, the Zarit burden Interview and the Instrument of burden of chronic illness for the patient were used. An analysis was made based on descriptive statistics and measures of central tendency, to know the profile of the participating dyads; Spearman correlation tests and canonical correlation were used; And non-parametric tests to evaluate the behavior of the variables of the selected measurement instruments. Results: It is corroborated that the female gender is predominant in the dyads and in productive age. The dyads of the study were characterized by taking little time of care. Family caregivers had a low overload and people with cancer expressed feelings ofemotional, physical and occupational aspects. We identified a weak relationship between caregiver andperson with cancer loads from Spearman correlation tests and canonical coefficient. Indicators of theburden on the quality of life mediated by the wells measured in the dyad through the Kruskall Wallistest, related to cultural and economic factors, were determined; and physical and psycho-emotionalwell-being. Conclusions: The dyads are in an individualized coping mediated by a short time link,present in the early stages of chronic disease; However, there are some characteristics that merit furtherresearch to deepen the phenomenon.

Pollutants Source Control and Health Effects

In the current special issue, different aspects of controlling pollutants and their health effects are being discussed. Considering the vicious cycle of rapid urbanization and increasing levels of air pollution, public health and regulatory policies for environmental protection and controlling pollutants from their sources should be integrated into the main priorities of the primary health care system and into the educational curriculum of health professionals [1, 2]. Discovery of the environmental exposures is of crucial importance. It may contribute to or protect against injuries, illnesses, developmental conditions, disabilities, and deaths and the identification of public health and health care actions to avoid, prepare for, and effectively manage the risks associated with harmful exposures. Control of emissions and effluents into air, water, or soil has several beneficial effects at global level [3]. Environmental pollution influences human's health before conception and continues during pregnancy, childhood, and adolescence to adult life [4–6]. It is suggested that such health hazards may represent the greatest public health challenge humanity has faced till now. Studying the effects of environmental factors on the early stages of chronic diseases can serve for future studies and offer strategies for primary preventive interventions [7]. The current special issue seeks to define source control of pollutants and the articles which are related to interaction between environmental pollutants and their effects on health. Its potential topics include recent developments in source control of pollutants, advances in environmental epidemiology, evaluation of mechanisms for action of environmental exposures, the influence of environmental pollutants on human health, and identification of public health and health care policies and measures for risk management. Roya Kelishadi Mohammad Mehdi Amin Ali Akbar Haghdoost Ajay K. Gupta Tuula Anneli Tuhkanen

Status Of Exercise Intervention For Chronic Disease In China

PURPOSE: To introduce the status of exercise intervention for chronic disease in China. METHODS: Literature consultation and interview method. With exercise prescription as keyword, and chronic disease and sports as theme author searched Chinese Journal Database for relevant papers in the past 10 years. RESULTS: 1) Relevant research papers: With exercise prescription as keyword, totally 2664, 2282 from 2000 and 387 from core journals, and with chronic disease and sports as theme, totally 794, 671 from 2000 and 129 from core journals. 10% of the 344 manuscripts in exchange of sport medicine in the 8th National Sport Science Conference were about exercise prescription for chronic disease. 2) Relevant research programs: There are more than 10 programs related with exercise prescription for chronic disease, holding by National Science and Technology Ministry, such as, 'Research and Application of Scientific Guide System for Exercise' and 'Research of Nation-wide Exercise Key Technologies and Development of Health Information System', Beijing Educational Committee, General Administration of Sport. All the projects involve assessment of risks in exercises and researches about exercise intervention for chronic disease, which includes high blood pressure, pre-diabetes, diabetes, obesity, lipid metabolism disorders, and osteoporosis and so on. CONCLUSIONS: 1) Most researches are experimental, with individualized exercise prescription as way of exercise intervention, mainly aiming at the early stage of chronic disease and early stage. 2) The exercise prescription uses the FITT model. 3) The chronic disease intervention often lasts 8-12 weeks. 4) Scientific study of exercise prescription and individual characteristics are more and more prominent and there have been a number of researches about various genetic polymorphism effects. 5) More and more attention paid on the necessity of health assessment before setting up an exercise prescription, evaluation of cardiovascular disease risk factors, and risk stratification and medical supervision during fitness testing and the implementation of exercise prescription. This paper supports by foundation of National Science and Technology Support Program in China (PROJECT No.: 2006BAK33B04).

Institutionalization of Older People: Prediction and Prevention

Expenditure on long-term care is likely to increase with the aging of the population and the increased need for institutionalization. Identifying risk factors for nursing home admission is of particular interest to develop predictive tools and intervention programs to reduce entry into nursing homes. Most of the patient-related risk factors leading to nursing home admission are based on an underlying decline in physical and/or cognitive functions. Interaction between caregiver and care recipient characteristics is also an important contributing factor. Structured preventive programs are more effective than individual counseling. Tailoring intervention programs to individual needs and preferences, continuous and comprehensive support of patients and their caregivers with access to a geriatrician is an important factor in the success of an intervention. Further research is still required to explore whether interventions at early stages of chronic diseases would delay physical and cognitive dysfunction and reduce the institutionalization of older people.

Reverse Race and Ethnic Disparities in Survival Increase with Severity of Chronic Kidney Disease

End-stage renal disease (ESRD) is more prevalent among black Americans (1). Early studies suggested that this was due to a higher incidence of renal disease progression, but evidence was lacking about rates of disease initiation or prevalence of early stages of chronic disease (2–3). More recently a higher prevalence of milder stages of kidney disease in blacks versus whites has been ruled out, suggesting that initiation of disease is not more common among blacks (4–6). Even more strongly, this evidence suggests that accelerated rates of renal disease progression at later stages are responsible for the higher incidence of ESRD among blacks. In this issue of CJASN , Newsome et al. provide intriguing evidence from the Cooperative Cardiovascular Project that there is a survival advantage for black chronic kidney disease patients and, most importantly, that it begins well before patients develop ESRD (7). From this large-scale quality improvement project begun in 1992 (8), Newsome et al. designed a retrospective cohort study of nearly 60,000 persons age ≥65 yr who were admitted for a first episode of acute myocardial infarction and followed passively for death over 3 yr using government records. The authors found that the magnitude of the survival advantage for blacks increases as GFR, estimated from the Modification of Diet in Renal Disease equation, decreases. …

Human population studies with cytogenetic biomarkers: Review of the literature and future prospectives

Cytogenetic biomarkers are by far the most frequently used endpoints in human population studies. Their sensitivity for measuring exposure to genotoxic agents and their role as early predictors of cancer risk have contributed to this success. In this article, we present an overview of the last 25 years of population studies with cytogenetic biomarkers, describing the evolution of this research and addressing the most promising innovations for the future. The evaluation has been restricted to the most popular assays, i.e., chromosomal aberrations (CAs) and micronucleus (MN), which are considered to be causally related to early stages of chronic diseases, especially cancer, and may therefore play a major role in prevention. An extensive literature search covering the period 1 January 1980 to 31 December 2003 was performed using the Medline/PubMed database. A total of 833 population studies using CAs and 434 using matched MN inclusion criteria were included in the analysis. We report the distribution of selected papers by year of publication, country, language, agents investigated, and methods employed. The state of the art and future prospects regarding cytogenetic techniques and epidemiologic and statistical methods are discussed. The role of susceptibility and its potential impact on genotoxic damage are discussed with special attention to the effect of major genetic polymorphisms on the baseline frequency of CAs and micronuclei.

CHARACTERIZATION OF CHRONIC HEPATITIS B IN CHILDHOOD USING MOLECULAR BIOLOGY TECHNIQUES

The introduction of molecular biology techniques in the diagnostics of chronic hepatitis B virus infection proved HBV DNA to be the most sensitive marker of viral replication and infectivity. The aim of our study was to characterize the HBV DNA status in children with chronic hepatitis B with various molecular biology techniques in relation to conventional HBV markers.Methods: 206 sera of 172 and liver tissue of 108 children with chronic hepatitis B infection were investigated by dot blot-, Southern blot-, and in situ hybridization. In dot blot and Southern blot negative specimens polymerase chain reaction (PCR) was performed.Results: 111 of the 206 sera were positive for HBV DNA by dot blot hybridization. 78% of these patients had HBeAg and 7.7% anti-HBc. In 60 (92.3%) of the anti-HBc positive sera no HBV DNA could be delected. 83.9% of the dot blot negative children were HBV DNA positive by PCR comprising all HBeAg positive and 80% of the anti-HBc positive cases. HBV DNA studies in liver tissue by Southern blot revealed free HBV DNA in 74/103 (71.8%). HBV DNA integration was present in 2 children (1.9%). PCR in the Southern blot negative tissue specimens confirmed the presence of viral sequences in all HBeAg and in 63% of anti-HBc positive cases. In situ hybridization was applied to tissue sections of 63 children. HBV DNA was detected in 48 patients. 40 were HBeAg- and 6 anti-HBc positive. The distribution of HBV DNA in the tissue was classified as homogeneous, inhomogencous with focal patches and focal.Conclusions: In conclusion our results demonstrate that all HBeAg- and most of the anti-HBc positive children show viral sequences in serum and liver. Integration of HBV DNA into the liver cell genome can occur at an early stage of chronic disease but is not a very frequent event. Finally, in situ hybridization is a reliable method to delect HBV DNA in small amounts of liver tissue and to provide informations about the distribution of replicative viral sequences.

Hepatitis B virus DNA in liver tissue of chronic HBsAg carriers in childhood and its relationship to other viral markers.

The aim of the study was to examine the state of hepatitis B virus (HBV) DNA in liver tissue of 103 children with chronic hepatitis B aged 0.5-18 years to detect free and integrated viral sequences by Southern blot hybridization. HBV DNA was found in 74 patients. Seventy-two were seropositive for hepatitis B e antigen (HBeAg) and two had anti-HBe antibodies. Integrated sequences could be demonstrated in two children. One of them had only integrated HBV DNA and was anti-HBe seropositive. The other one presented both free and integrated viral sequences and developed seroconversion from HBeAg to anti-HBe 5 months after biopsy. In 29 hepatitis B surface antigen (HBsAg) carriers, no HBV DNA could be detected in the liver. Ten were HBeAg and 19 anti-HBe seropositive. HBV DNA in serum was found in 65 of the 74 Southern blot-positive and only in two cases of the Southern blot-negative patients. In conclusion, most of the HBeAg-positive children had free HBV DNA in their liver tissue and all patients with anti-HBe except one were negative. According to our results, HBV DNA integration into the liver cell genome can occur at an early stage of chronic disease but is not a frequent event.

Hepatitis B Virus DNA in Liver Tissue of Chronic HBsAg Carriers in Childhood and Its Relationship to Other Viral Markers

The aim of the study was to examine the state of hepatitis B virus (HBV) DNA in liver tissue of 103 children with chronic hepatitis B aged 0.5–18 years to detect free and integrated viral sequences by Southern blot hybridization. HBV DNA was found in 74 patients. Seventy‐two were seropositive for hepatitis B e antigen (HBcAg) and two had anti‐HBe antibodies. Integrated sequences could be demonstrated in two children. One of them had only integrated HBV DNA and was anti‐HBe seropositive. The other one presented both free and integrated viral sequences and developed seroconversion from HBeAg to anti‐HBe 5 months after biopsy. In 29 hepatitis B surface antigen (HBsAg) carriers, no HBV DNA could be detected in the liver. Ten were HBeAg and 19 anti‐HBe seropositive. HBV DNA in serum was found in 65 of the 74 Southern blot‐positive and only in two cases of the Southern blot‐negative patients. In conclusion, most of the HBeAg‐positive children had free HBV DNA in their liver tissue and all patients with anti‐HBe except one were negative. According to our results, HBV DNA integration into the liver cell genome can occur at an early stage of chronic disease but is not a frequent event.